| NPI | 1417024787 |
|---|---|
| Former Name | GLENA LYNNE NEEDHAM SCHUBARTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OR 2560) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 2560) |
| 103TH0100X Psychologist, Health Service (Licence: OR 2560) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-09-14 |