NPI | 1174561641 |
---|---|
Former Name | LAURIE C BERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CO 2931) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CO 582AC) |
103TC1900X Psychologist, Counseling (Licence: CO 2653) | |
Enumeration Date | 2006-06-04 |
Last Update Date | 2007-07-08 |