| NPI | 1174674501 |
|---|---|
| Former Name | TARA KATHLEEN GIDNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8628) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 71007131) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2013-03-05 |