NPI | 1982158390 |
---|---|
Former Name | ELIZABETH MADELEINE ORTON FIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018927) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-08-15 |
Last Update Date | 2019-12-28 |