| NPI | 1497148241 |
|---|---|
| Former Name | SUSAN MARIE KAMINSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10089) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-03-17 |