| NPI | 1437452018 |
|---|---|
| Former Name | JORDAN MICHELLE LUTEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2608) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY60949986) |
| 103TC0700X Psychologist, Clinical (Licence: MT PSYPSYLIC3612) | |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2021-09-28 |