NPI | 1770729139 |
---|---|
Former Name | STACIE ANN CRAFT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 35210) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 70244) |
Enumeration Date | 2009-01-06 |
Last Update Date | 2024-09-05 |