NPI | 1649378159 |
---|---|
Former Name | JAN SNYDER PEREA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY4507) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 3642) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2007-07-08 |