NPI | 1609064088 |
---|---|
Former Name | REBECCA ALLEN-BURGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 904) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: AL 904) |
Enumeration Date | 2007-10-10 |
Last Update Date | 2007-10-10 |