NPI | 1124269428 |
---|---|
Former Name | JULIE ELIZABETH SURBAUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 017851) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 35510061300) |
103T00000X Psychologist (Licence: CT 004121) | |
Enumeration Date | 2009-03-16 |
Last Update Date | 2023-02-24 |