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 |