NPI | 1477883668 |
---|---|
Former Name | MARY D.C. LAUTERBACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 2889) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TN P2889) |
Enumeration Date | 2010-01-11 |
Last Update Date | 2017-10-30 |