| NPI | 1497120620 |
|---|---|
| Former Name | ELIZABETH HAZEL LAITMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.011155) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |