NPI | 1801361282 |
---|---|
Former Name | AMBER HOLLOWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2019036248) |
Additional Taxonomies | 103T00000X Psychologist (Licence: KS 2837) |
Enumeration Date | 2018-10-11 |
Last Update Date | 2019-11-13 |