| NPI | 1275281669 |
|---|---|
| Former Name | JACQUELINE DIANE RUVO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2021004232) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 25876) |
| 103TC0700X Psychologist, Clinical (Licence: MD 06316) | |
| 103TC0700X Psychologist, Clinical (Licence: KS 02989) | |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-03-14 |