NPI | 1952070377 |
---|---|
Former Name | BROOKE HEATHER GENKIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000117) |
Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS01934) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: RI PS01934) | |
103TC0700X Psychologist, Clinical (Licence: RI PS01934) | |
103TH0004X Psychologist, Health (Licence: RI PS01934) | |
Enumeration Date | 2021-09-09 |
Last Update Date | 2023-12-18 |