NPI | 1811127251 |
---|---|
Former Name | MICHELLE LEA THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2659057) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071004708) |
Enumeration Date | 2009-07-20 |
Last Update Date | 2009-07-20 |