| NPI | 1598008104 |
|---|---|
| Former Name | SHELBY NICOLE SPARE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY KY-1722) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6959) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2013-04-02 |