| NPI | 1053419945 |
|---|---|
| Former Name | CYNTHIA LORRAINE DALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WV 631) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WV 631) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WV 631) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-09 |