NPI | 1578980538 |
---|---|
Former Name | STEPHANIE K POGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3861) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023102) |
Enumeration Date | 2014-03-27 |
Last Update Date | 2020-06-04 |