NPI | 1124640578 |
---|---|
Former Name | LEISZLE RAE ZIEMBA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071010311) |
Additional Taxonomies | 103T00000X Psychologist |
Enumeration Date | 2020-05-08 |
Last Update Date | 2020-10-14 |