NPI | 1740378850 |
---|---|
Former Name | SUSAN LAURA OWRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1677) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071004327) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2007-07-26 |