| NPI | 1154042166 |
|---|---|
| Former Name | SUSAN ANN LI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 2105) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: OR 2105) |
| 103TH0100X Psychologist, Health Service (Licence: OR 2105) | |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-01-26 |