NPI | 1568852952 |
---|---|
Former Name | MARY/CAROL ROBERT CLARE/ROBERTA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OH 7217) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005000) |
221700000X Art Therapist (Licence: 98-119) | |
Enumeration Date | 2015-01-23 |
Last Update Date | 2015-05-30 |