NPI | 1841543113 |
---|---|
Former Name | JODI RUBLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: MO SChool Psychologist) |
Additional Taxonomies | 174400000X Specialist (Licence: NE 2012002507) |
Enumeration Date | 2012-10-23 |
Last Update Date | 2012-10-23 |