NPI | 1174657902 |
---|---|
Former Name | HEATHER JEAN GUMM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY25944) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC29054) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2019-11-05 |