NPI | 1316349061 |
---|---|
Former Name | LINDSEY ANN BRUCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 4780) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 15258) |
Enumeration Date | 2014-09-24 |
Last Update Date | 2016-10-31 |