NPI | 1790011492 |
---|---|
Former Name | MARY MIGUEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 34032) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-10-30 |
Last Update Date | 2023-03-13 |