NPI | 1083912034 |
---|---|
Other Name | JEFFRY STINE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008039) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071008039) |
Enumeration Date | 2011-02-28 |
Last Update Date | 2019-06-24 |