is a Clinical in , . practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1841340239. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1841340239 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
| Post Code | |
| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
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| Taxonomy | 103Tc0700X |
| Licence No | 615 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PSO211 | SC | -- |
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