NPI | 1821575663 |
---|---|
Former Name | SARAH FETTER ANTHONEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: IA 001289) |
Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: IA 091623) |
Enumeration Date | 2018-07-24 |
Last Update Date | 2023-11-03 |