Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY 2735 | FL |
Y | 103TC0700X | Clinical Psychologist | PY 2735 | FL |
NPI | 1003926650 |
---|---|
Provider Name | Dr. Judith Barlow Demontmollin |
First Address | Gainesville, FL 32606-3948 |
Second Address | Gainesville, FL 32608-1135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |