NPI | 1194846253 |
---|---|
Other Name | BETH LUSBY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 30807) |
Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 30807) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2007-07-08 |