| NPI | 1649440645 |
|---|---|
| Former Name | LAURA HUMPHREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071.004111) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071004111) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2012-10-09 |