| NPI | 1568655637 |
|---|---|
| Former Name | DEIDRA LOUISE MCGIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS LCP - 269) |
| 103TF0000X Psychologist, Family (Licence: KS LCP - 269) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2013-10-23 |