NPI | 1245607597 |
---|---|
Former Name | ELIZABETH SARA MOLZON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05850) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05850) |
Enumeration Date | 2015-08-21 |
Last Update Date | 2024-02-01 |