NPI | 1154741841 |
---|---|
Former Name | AMY NOELLE ANDRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PSO17542) |
Additional Taxonomies | 103T00000X Psychologist |
103T00000X Psychologist (Licence: PA PS017542) | |
Enumeration Date | 2014-04-21 |
Last Update Date | 2020-09-23 |