| NPI | 1306944384 |
|---|---|
| Former Name | LORI B LISTUG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP4748) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DE B10000729) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP 4748) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-08 |