NPI | 1487789624 |
---|---|
Professional Name | JOE ETHERTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 32701) |
Additional Taxonomies | 103T00000X Psychologist (Licence: LA 863) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2018-01-25 |