NPI | 1669807111 |
---|---|
Former Name | LORI BETH HAASE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA 25817) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 25817) |
Enumeration Date | 2013-09-03 |
Last Update Date | 2024-04-25 |