NPI | 1730540014 |
---|---|
Former Name | MEGAN A TUCKER |
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI PS01864) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 10739) |
Enumeration Date | 2016-03-14 |
Last Update Date | 2024-11-11 |