| NPI | 1417206376 |
|---|---|
| Former Name | AVIVAH MCDADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PS-T001100) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 32009) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2022-08-10 |