NPI | 1588109086 |
---|---|
Former Name | REBECCA CLAUSIUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2022014080) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.009433) |
103TC0700X Psychologist, Clinical (Licence: CO 5135) | |
Enumeration Date | 2016-12-20 |
Last Update Date | 2022-07-12 |