| NPI | 1093192874 |
|---|---|
| Former Name | ANDREA LEWALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY28819) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 103TC2200X) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2019-09-11 |