NPI | 1336415637 |
---|---|
Other Name | JACKIE CAMP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5082) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20042737A) |
103TC0700X Psychologist, Clinical (Licence: IN 20042737A) | |
Enumeration Date | 2012-03-30 |
Last Update Date | 2021-02-05 |