NPI | 1184779100 |
---|---|
Former Name | LINDA ELAINE OLSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: AK PSYP226) |
Additional Taxonomies | 103T00000X Psychologist (Licence: AK AA226) |
103T00000X Psychologist (Licence: AZ PSY-005205) | |
103T00000X Psychologist (Licence: CA PA6482) | |
Enumeration Date | 2007-01-23 |
Last Update Date | 2021-05-07 |