| NPI | 1881890762 |
|---|---|
| Former Name | STEPHANIE JEAN WINGATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS009291L) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS009291L) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-07-08 |