NPI | 1740041466 |
---|---|
Former Name | CHARLETTE MARIE HULTQUIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 3188) |
Additional Taxonomies | 101YS0200X Counselor, School |
103TS0200X Psychologist, School (Licence: CA 3188) | |
Enumeration Date | 2024-01-19 |
Last Update Date | 2024-01-19 |