NPI | 1225296767 |
---|---|
Former Name | JORDAN ELIZABETH WALDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2008013472) |
Enumeration Date | 2008-05-31 |
Last Update Date | 2008-05-31 |