NPI | 1558810580 |
---|---|
Doing Business As | M.L. REARDON, PH.D., ABPP |
Entity Type | Organization |
Authorized Contact | MAUREEN LYONS REARDON Owner 910-609-1990 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: NC 3149) |
Enumeration Date | 2016-10-03 |
Last Update Date | 2016-10-12 |