NPI | 1689980302 |
---|---|
Former Name | JENNIFER ERIN STEVENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation (Licence: WA PY60137402) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY60137402) |
Enumeration Date | 2010-08-19 |
Last Update Date | 2020-05-18 |