NPI | 1629253414 |
---|---|
Former Name | CAROLE LEIGH CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 1327) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810003901) |
Enumeration Date | 2007-12-31 |
Last Update Date | 2021-12-02 |