NPI | 1104061605 |
---|---|
Former Name | AMY COFFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041902A) |
Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: IN 20041902A) |
Enumeration Date | 2008-12-11 |
Last Update Date | 2023-12-26 |