NPI | 1497010953 |
---|---|
Former Name | ASHLI BROOKE WALTERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS018557) |
Additional Taxonomies | 103T00000X Psychologist |
Enumeration Date | 2012-07-11 |
Last Update Date | 2020-08-31 |