NPI | 1538694211 |
---|---|
Former Name | ANDREA WOLFE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006382) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-05-01 |
Last Update Date | 2023-09-22 |