NPI | 1023341450 |
---|---|
Former Name | ABIGAIL LAURIE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 5340) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 7051) |
Enumeration Date | 2009-09-17 |
Last Update Date | 2023-07-06 |