NPI | 1760977128 |
---|---|
Former Name | EMILY FOXEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301016822) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016822) |
Enumeration Date | 2018-06-28 |
Last Update Date | 2020-11-02 |