NPI | 1467643296 |
---|---|
Former Name | LISA M O'BRIEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 130232) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY KY1351) |
103TC0700X Psychologist, Clinical (Licence: KY 1531) | |
Enumeration Date | 2007-08-07 |
Last Update Date | 2022-03-02 |