NPI | 1023750692 |
---|---|
Former Name | MEGAN LEA GRAVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DC PSY200001730) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-04-12 |
Last Update Date | 2025-09-24 |