| NPI | 1003690447 |
|---|---|
| Former Name | TED DOUGLAS ALLAIRE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS010173) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301019335) |
| 103T00000X Psychologist (Licence: PA PS010173) | |
| 103G00000X Clinical Neuropsychologist (Licence: MI 6301019335) | |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2024-08-28 |