NPI | 1265729446 |
---|---|
Former Name | ERICA MONTAGUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7175) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NH 7104) |
Enumeration Date | 2011-07-07 |
Last Update Date | 2025-07-25 |