| NPI | 1700368578 | 
|---|---|
| Former Name | DANIELLE UMLAND RANDALL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3996-57)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AR 18-17P)  | 
| Enumeration Date | 2018-08-29 | 
| Last Update Date | 2024-01-02 |