NPI | 1013353531 |
---|---|
Former Name | ABIGAIL DIANA MINTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: DC PSY1000932) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05113) |
Enumeration Date | 2013-05-13 |
Last Update Date | 2024-11-29 |