NPI | 1811130735 |
---|---|
Former Name | HEIDI DYLANI MONTOYA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation (Licence: WA PY60336314) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA 60336314) |
Enumeration Date | 2009-04-07 |
Last Update Date | 2019-07-12 |