NPI | 1063672574 |
---|---|
Former Name | JENNIFER E ROSADO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 5930) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH P7219) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2008-06-10 |
Last Update Date | 2021-09-01 |