| NPI | 1083098974 |
|---|---|
| Former Name | AMANDA RICKARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 290448) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY003907) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2025-03-03 |