NPI | 1487104519 |
---|---|
Former Name | ALISON LUNDBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.011237) |
103TC0700X Psychologist, Clinical (Licence: MN 6999) | |
Enumeration Date | 2016-10-13 |
Last Update Date | 2025-01-17 |