NPI | 1518164193 |
---|---|
Former Name | SHARON BUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 014154-1) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 003889) |
Enumeration Date | 2007-06-28 |
Last Update Date | 2025-09-19 |