NPI | 1346625902 |
---|---|
Former Name | AMBER JUNE GORZYNSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 263092) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-07-24 |
Last Update Date | 2021-08-24 |