| NPI | 1326337965 | 
|---|---|
| Other Name | LAURIE K SHANK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 100250)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 2915-57)  | 
| Enumeration Date | 2011-04-05 | 
| Last Update Date | 2020-04-21 |