| NPI | 1891334595 |
|---|---|
| Former Name | ASHLEY ALAYNA MAKULOWICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06524) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS018904) |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2020-11-04 |