| NPI | 1417143231 |
|---|---|
| Other Name | JACQUELINE ANN TABACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 025195) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 025195) |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2018-02-09 |