NPI | 1811411861 |
---|---|
Former Name | ASHLI G ROLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 5891) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NC 5891) |
103TC0700X Psychologist Clinical (Licence: TX 37456) | |
Enumeration Date | 2017-08-01 |
Last Update Date | 2024-09-19 |