NPI | 1487665584 |
---|---|
Former Name | JENNIFER REBEKAH HIEMENZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NC 2648) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 2648) |
Enumeration Date | 2006-08-11 |
Last Update Date | 2019-10-15 |