| NPI | 1356419790 |
|---|---|
| Former Name | LARONTA M UPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA 003025) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA 003025) |
| 103TS0200X Psychologist, School (Licence: GA 003025) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2024-08-14 |