| NPI | 1689737595 |
|---|---|
| Former Name | JODI RAE GLAUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2003030079) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MO 2003030079) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2009-04-06 |