| NPI | 1194964932 |
|---|---|
| Former Name | EILEEN C. FASOLI LUSSIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY19249) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: CA PSY19249) |
| 103TA0700X Psychologist Adult Development & Aging (Licence: CA PSY19249) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY19249) | |
| 103TH0100X Psychologist Health Service (Licence: CA PSY19249) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: CA PSY19249) | |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2012-10-06 |