| NPI | 1114095668 |
|---|---|
| Former Name | DIANE RENE SHELTON-MCBRYDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3231) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 2374) |
| 103TC0700X Psychologist, Clinical (Licence: AZ 3585) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY24661) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY9759) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-01-04 |