NPI | 1598077737 |
---|---|
Former Name | LAUREN PALAZZOLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60806123) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60800543) |
103TC0700X Psychologist, Clinical (Licence: MI 6301012102) | |
Enumeration Date | 2010-07-02 |
Last Update Date | 2021-03-22 |