| NPI | 1235807512 |
|---|---|
| Former Name | STEFANIE ALISON MOYNIHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61149309) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 07009) |
| 103TC0700X Psychologist, Clinical (Licence: KS LP03048) | |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2023-08-25 |