NPI | 1639335904 |
---|---|
Former Name | ELIZABETH BREESE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4381) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OR 1931) |
Enumeration Date | 2008-08-05 |
Last Update Date | 2018-01-08 |