| NPI | 1023485646 |
|---|---|
| Former Name | EMILIA SUE BOESCHEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: SD 538) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SD 538) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: SD 538) | |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2015-12-30 |