NPI | 1801059043 |
---|---|
Former Name | LISA DAWN HINKLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 175264) |
Additional Taxonomies | 103T00000X Psychologist (Licence: KY 0905) |
Enumeration Date | 2008-07-08 |
Last Update Date | 2018-03-17 |