NPI | 1629233812 |
---|---|
Former Name | BETH JANEL LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04154) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000435) |
Enumeration Date | 2008-07-28 |
Last Update Date | 2009-08-20 |