NPI | 1740680388 |
---|---|
Former Name | COLLEEN JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS018396) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 021864) |
Enumeration Date | 2014-09-02 |
Last Update Date | 2018-03-17 |