NPI | 1215019393 |
---|---|
Other Name | JERRY FRED BARBA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY19013) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY19015) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2021-10-23 |