NPI | 1538262191 |
---|---|
Former Name | GAYLE GENEVIEVE VINCENT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005505) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: IL 071005505) |
Enumeration Date | 2006-09-07 |
Last Update Date | 2007-07-08 |