NPI | 1568894541 |
---|---|
Former Name | CRYSTAL CONSTANCE LOZIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA 60650636) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-08-01 |
Last Update Date | 2024-12-26 |