NPI | 1891075818 |
---|---|
Former Name | JOCLYN GORDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 014732) |
Enumeration Date | 2011-08-22 |
Last Update Date | 2023-11-14 |