| NPI | 1114148798 |
|---|---|
| Former Name | MIRANDA GILMORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5423) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA RPS2010006) |
| 103TC0700X Psychologist, Clinical (Licence: MN GL0006) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY24149) | |
| 106H00000X Marriage & Family Therapist (Licence: MN 2599) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 46860) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 51386) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-08-21 |