NPI | 1841497864 |
---|---|
Former Name | LAURA JEAN FARMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP 4759) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP 4759) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2007-07-10 |