NPI | 1962817593 |
---|---|
Former Name | COURTNEY CAPRICE HIVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1595) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-06-23 |
Last Update Date | 2021-05-28 |