NPI | 1265509368 |
---|---|
Former Name | SUELLEN WALSH ROTHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9499) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9499) |
103TF0000X Psychologist, Family (Licence: MA 9499) | |
Enumeration Date | 2006-11-30 |
Last Update Date | 2020-01-07 |