| NPI | 1609438878 |
|---|---|
| Former Name | REBECCA ELYSE HEIDELBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 3593) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TN 3593) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2025-02-07 |