| NPI | 1952415309 |
|---|---|
| Former Name | TERRIE LYNN FISK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MO 01299) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: KS 0694) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |