NPI | 1770964884 |
---|---|
Former Name | STACY LYNN DARR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MD 05820) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-06-15 |
Last Update Date | 2020-01-09 |