NPI | 1124518741 |
---|---|
Former Name | AMANDA HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS020194) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2018-05-18 |
Last Update Date | 2024-07-05 |