| NPI | 1295069839 |
|---|---|
| Former Name | MARY ELIZABETH BANCROFT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM 1222) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2021-01-22 |