NPI | 1710411244 |
---|---|
Former Name | LAURA MCINTIRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 266047) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4901) |
Enumeration Date | 2017-04-11 |
Last Update Date | 2020-12-08 |