NPI | 1952794422 |
---|---|
Former Name | CARLY PARNITZKE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3324) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS018685) |
Enumeration Date | 2015-03-09 |
Last Update Date | 2024-03-14 |