NPI | 1497187298 |
---|---|
Former Name | LEAH MICHELLE VAN GRINSVEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3288) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NE 10009) |
Enumeration Date | 2013-08-02 |
Last Update Date | 2022-02-02 |