| NPI | 1689749384 |
|---|---|
| Former Name | GERALD LEE GAFFIN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS006097L) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: PA PS006097L) |
| 103TA0700X Psychologist Adult Development & Aging (Licence: OH 4793) | |
| 103TC0700X Psychologist Clinical (Licence: OH 4793) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS006097L) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OH 4793) | |
| 103T00000X Psychologist (Licence: PA PS006097L) | |
| 103T00000X Psychologist (Licence: OH 4793) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2016-04-25 |