NPI | 1619506854 |
---|---|
Former Name | ANITA MARIE VITALE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12368) |
Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810006450) |
103TC0700X Psychologist, Clinical (Licence: VA 0810006450) | |
Enumeration Date | 2020-04-08 |
Last Update Date | 2024-09-27 |