| NPI | 1518302009 |
|---|---|
| Former Name | JERRI VANDENBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY8740) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 008821) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2013-05-09 |