NPI | 1881950665 |
---|---|
Former Name | LAURA THERESE LYMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 299418) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101256239) |
Enumeration Date | 2012-04-06 |
Last Update Date | 2021-10-14 |