NPI | 1386257665 |
---|---|
Former Name | AMY NICOLE GILES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 36288) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2020-08-26 |
Last Update Date | 2021-07-22 |