NPI | 1023419348 |
---|---|
Former Name | LISA ANNETTE PAUL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071.008678) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071008678) |
Enumeration Date | 2014-09-05 |
Last Update Date | 2020-10-03 |