NPI | 1619287208 |
---|---|
Former Name | LISA MICHELLE SUGERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: UT 6278375-2501) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 6278375-2501) |
Enumeration Date | 2010-10-15 |
Last Update Date | 2024-10-29 |