NPI | 1306146899 |
---|---|
Former Name | ANGIE L PELLEGRIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36321) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 1154) |
Enumeration Date | 2010-10-29 |
Last Update Date | 2021-06-04 |