NPI | 1932500550 |
---|---|
Former Name | COURTNEY ANN POLLMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005355) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-09-15 |
Last Update Date | 2018-03-17 |