| NPI | 1649233909 |
|---|---|
| Former Name | JANIS DIANE EDISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 00895) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS-006763-L) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2007-07-08 |