NPI | 1831487602 |
---|---|
Former Name | REBECCA SUE BAUKNIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 16271) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 16271) |
103TP0814X Psychologist, Psychoanalysis | |
Enumeration Date | 2011-07-14 |
Last Update Date | 2011-07-14 |