| NPI | 1578211298 |
|---|---|
| Other Name | ELLEN PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 024786) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2022-04-06 |