NPI | 1154652030 |
---|---|
Former Name | CASEY JENNIFER HADDAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9406) |
Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: FL 9406) |
103G00000X Clinical Neuropsychologist (Licence: FL 9406) | |
Enumeration Date | 2010-01-16 |
Last Update Date | 2021-03-18 |