NPI | 1356787345 |
---|---|
Former Name | SARAH ANN VAN DYKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301014869) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014869) |
Enumeration Date | 2013-05-16 |
Last Update Date | 2021-03-02 |