NPI | 1477021657 |
---|---|
Former Name | JANETTE MAE LABURN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301007137) |
Enumeration Date | 2018-11-06 |
Last Update Date | 2020-04-13 |