| NPI | 1518584986 |
|---|---|
| Former Name | AMBER NIKOLE BATES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 5727) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 5727) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2023-04-24 |