| NPI | 1134460926 |
|---|---|
| Former Name | LAURA SPRAGUE ANDERSON-KLONTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: HI PSY 680) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI PSY 680) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2013-03-05 |