NPI | 1124436530 |
---|---|
Former Name | ALICIA KAUFFMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 38772) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2014-07-29 |
Last Update Date | 2021-10-12 |