NPI | 1982998910 |
---|---|
Former Name | BARBARA JEAN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004420) |
Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810004420) |
Enumeration Date | 2011-06-07 |
Last Update Date | 2021-02-25 |