NPI | 1700428737 |
---|---|
Former Name | TRACY VARGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY32590) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
Enumeration Date | 2019-10-10 |
Last Update Date | 2024-04-30 |