NPI | 1073871505 |
---|---|
Former Name | KATIE PETERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY9067) |
Additional Taxonomies | 101Y00000X Counselor |
103TC1900X Psychologist, Counseling | |
103TF0200X Psychologist, Forensic | |
103TC0700X Psychologist, Clinical (Licence: FL PY9067) | |
Enumeration Date | 2012-05-03 |
Last Update Date | 2016-02-02 |