NPI | 1760526792 |
---|---|
Former Name | BARBARA S GLINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 2152) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 2152) |
103T00000X Psychologist (Licence: MD 2152) | |
Enumeration Date | 2007-02-15 |
Last Update Date | 2015-02-06 |