NPI | 1720265796 |
---|---|
Former Name | LAKEASHA GARNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PS-T001046) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017515) |
Enumeration Date | 2008-01-22 |
Last Update Date | 2019-03-19 |