NPI | 1720367980 |
---|---|
Former Name | NICHOLE L WOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7011) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OK 1058) |
Enumeration Date | 2011-08-05 |
Last Update Date | 2017-10-19 |