NPI | 1942568142 |
---|---|
Former Name | AMANDA CASSEL SWANK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: DE C1-0012328) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-25 |
Last Update Date | 2023-05-25 |