| NPI | 1336622513 |
|---|---|
| Former Name | MARY HUNDLEY WILLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 171260) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 3697) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |