| NPI | 1164597043 |
|---|---|
| Former Name | CAROLYN ELIZABETH DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY28831) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019200) |
| Enumeration Date | 2006-11-23 |
| Last Update Date | 2024-09-18 |