NPI | 1164805784 |
---|---|
Former Name | AMANDA BERNICE EYGES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSB94025397) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-07-01 |
Last Update Date | 2022-01-26 |