NPI | 1063947448 |
---|---|
Former Name | AMY MICHELLE DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 33630) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-04-24 |
Last Update Date | 2022-10-06 |