NPI | 1447280094 |
---|---|
Former Name | NANCY A JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005268) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WI 2003-57) |
Enumeration Date | 2006-07-03 |
Last Update Date | 2015-04-01 |