| NPI | 1568646891 |
|---|---|
| Former Name | SUSAN CAROL MUIR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 047-0000465) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VT 068-0000073) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2007-12-21 |