NPI | 1043610694 |
---|---|
Former Name | ABIGAIL STEVENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CO 4084) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY9120) |
103TC0700X Psychologist, Clinical (Licence: FL PY9120) | |
Enumeration Date | 2014-09-02 |
Last Update Date | 2021-10-27 |