NPI | 1316231756 |
---|---|
Former Name | EMILY ANN FITZGERALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 29973) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-06-02 |
Last Update Date | 2021-06-22 |