NPI | 1972845741 |
---|---|
Former Name | HEATHER M AMBROSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: VA 0810005214) |
Additional Taxonomies | 103T00000X Psychologist |
103TC0700X Psychologist, Clinical (Licence: VA 0810005788) | |
Enumeration Date | 2013-03-20 |
Last Update Date | 2023-08-08 |