NPI | 1114066347 |
---|---|
Former Name | JULIE WATTS LUTCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MA 104703) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NH 190) |
Enumeration Date | 2007-02-05 |
Last Update Date | 2007-07-08 |