NPI | 1669510806 |
---|---|
Former Name | CAROL ANN SACKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY5650) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 0092731) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2017-12-15 |