| NPI | 1134136831 |
|---|---|
| Former Name | CAROL OLIVIA COPELAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 2658) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS005532L) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 2658) | |
| 103TH0100X Psychologist, Health Service (Licence: CO 2658) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2018-06-07 |