NPI | 1013254846 |
---|---|
Former Name | NANCY LOIS PUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 17103) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 17103) |
103TF0200X Psychologist, Forensic (Licence: CA 17103) | |
Enumeration Date | 2013-01-14 |
Last Update Date | 2015-02-23 |