NPI | 1801132865 |
---|---|
Former Name | TAYLOR LUBITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA PSB36963) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY25953) |
Enumeration Date | 2012-12-19 |
Last Update Date | 2013-09-12 |