NPI | 1134265473 |
---|---|
Former Name | BRETT ELIZABETH LIEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3860) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 3860) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2013-07-18 |