NPI | 1295807105 |
---|---|
Former Name | MARYKATE SMITH-EBERLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: UT 9649381-2501) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NM 1120) |
103T00000X Psychologist (Licence: NY 015157-0) | |
Enumeration Date | 2006-11-15 |
Last Update Date | 2022-07-21 |