NPI | 1629424296 |
---|---|
Former Name | AMANDA RACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 3536) |
Additional Taxonomies | 103T00000X Psychologist (Licence: TN 3536) |
103TC0700X Psychologist, Clinical (Licence: TN P0000003536) | |
Enumeration Date | 2016-05-12 |
Last Update Date | 2024-09-10 |