NPI | 1679229280 |
---|---|
Former Name | CHELSEA MARIE BOUQUET |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2022027625) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
Enumeration Date | 2022-02-23 |
Last Update Date | 2024-04-11 |