NPI | 1811152994 |
---|---|
Former Name | LARA CROWDER-DYE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36382) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY17434) |
Enumeration Date | 2008-07-28 |
Last Update Date | 2012-11-20 |