NPI | 1235647470 |
---|---|
Former Name | LAURIE ANNE GAYES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071009687) |
Enumeration Date | 2018-01-22 |
Last Update Date | 2018-01-22 |