| NPI | 1366814758 |
|---|---|
| Former Name | SUSAN SKEPPSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071009536) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 178009626) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2017-04-18 |