NPI | 1912215260 |
---|---|
Former Name | GINGER LEIGH BURGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: IN 20042450A) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: IN 20042450A) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: IN 20042450A) | |
103TC0700X Psychologist, Clinical (Licence: IN 20042450A) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20042450A) | |
103TF0000X Psychologist, Family (Licence: IN 20042450A) | |
103TH0004X Psychologist, Health (Licence: IN 20042450A) | |
103TH0100X Psychologist, Health Service (Licence: IN 20042450A) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IN 20042450A) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: IN 20042450A) | |
Enumeration Date | 2010-09-21 |
Last Update Date | 2017-09-28 |