| NPI | 1356749766 |
|---|---|
| Former Name | GRACE YVETTE LANGEBECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 04767) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810004437) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-17 |