NPI | 1730368754 |
---|---|
Former Name | JAN LESLIE GRAYSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY12631) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY12631) |
Enumeration Date | 2007-10-26 |
Last Update Date | 2007-10-26 |