NPI | 1003968116 |
---|---|
Former Name | TRACIE L. MERTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: SC 686) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: SC 686) |
103TA0700X Psychologist Adult Development & Aging (Licence: SC 686) | |
103TB0200X Psychologist Cognitive & Behavioral (Licence: SC 686) | |
103TC0700X Psychologist Clinical (Licence: SC 686) | |
103TH0100X Psychologist Health Service (Licence: SC 686) | |
103TP2701X Psychologist Group Psychotherapy (Licence: SC 686) | |
103TR0400X Psychologist Rehabilitation (Licence: SC 686) | |
Enumeration Date | 2007-01-17 |
Last Update Date | 2021-07-08 |