NPI | 1487844882 |
---|---|
Former Name | VERONICA FENSKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 4214) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103T00000X Psychologist (Licence: VA 701004261) | |
Enumeration Date | 2007-07-31 |
Last Update Date | 2017-01-30 |