| NPI | 1104871789 |
|---|---|
| Former Name | SUSAN B SLEDGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 2833) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CO 2833) |
| 103TC0700X Psychologist Clinical (Licence: VA 0810002753) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-03-11 |