NPI | 1235959933 |
---|---|
Former Name | LAUREN RODRIGUEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS020086) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC0700X Psychologist, Clinical (Licence: NJ 35SI00741600) | |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2024-10-16 |
Last Update Date | 2024-10-16 |