NPI | 1407930142 |
---|---|
Former Name | PEGGY L CASDORPH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: WV 782) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 40151) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2012-05-22 |