NPI | 1013408137 |
---|---|
Former Name | MARA ELIZABETH WOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AR 17-24P) |
Additional Taxonomies | 103T00000X Psychologist (Licence: AR 17-24P) |
103TS0200X Psychologist, School (Licence: AR 17-24P) | |
Enumeration Date | 2018-05-24 |
Last Update Date | 2024-01-09 |