NPI | 1245356112 |
---|---|
Other Name | JUDITH DEGRAZIA WILLARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20042329A) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NV PY0315) |
103G00000X Clinical Neuropsychologist (Licence: AZ 1919) | |
Enumeration Date | 2007-03-22 |
Last Update Date | 2019-04-02 |