NPI | 1104086412 |
---|---|
Former Name | SHAUNA SPERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NE 1056) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6558) |
Enumeration Date | 2008-06-10 |
Last Update Date | 2022-01-18 |