| NPI | 1508331257 |
|---|---|
| Former Name | CAROLYN LASTRA RAFFEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0006222) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY.0006222) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2024-10-13 |