NPI | 1265842579 |
---|---|
Former Name | ELYSE COOLIDGE HUEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 11320286-1205) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 11320286-1205) |
Enumeration Date | 2014-05-08 |
Last Update Date | 2024-06-11 |