NPI | 1568844793 |
---|---|
Former Name | HOLLY M RUSINKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9053) |
Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY003586) |
Enumeration Date | 2015-06-24 |
Last Update Date | 2022-07-21 |