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 |