NPI | 1396135356 |
---|---|
Former Name | ASHLEY LYMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 4142) |
Additional Taxonomies | 103T00000X Psychologist (Licence: TX 36088) |
Enumeration Date | 2015-01-29 |
Last Update Date | 2021-12-26 |