| NPI | 1609112630 |
|---|---|
| Former Name | LAWANDA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9265) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY9265) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2019-07-29 |