NPI | 1043571565 |
---|---|
Former Name | JAMIE HAYNES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 079787) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY33941) |
Enumeration Date | 2012-05-31 |
Last Update Date | 2025-03-20 |