NPI | 1063705101 |
---|---|
Former Name | ANNETTE GINA EDWARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 34289) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY17997) |
Enumeration Date | 2011-05-23 |
Last Update Date | 2024-05-10 |