NPI | 1770969305 |
---|---|
Former Name | ALLIE DERANEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38916) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 5014) |
Enumeration Date | 2015-08-05 |
Last Update Date | 2021-09-02 |