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 |