NPI | 1134522055 |
---|---|
Former Name | AMANDA LOERINC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11374) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY31258) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-10-06 |
Last Update Date | 2024-06-26 |