NPI | 1639208309 |
---|---|
Former Name | LIBBY L BETHEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20041288A) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1068) |
Enumeration Date | 2007-03-05 |
Last Update Date | 2019-05-22 |