| NPI | 1659775104 |
|---|---|
| Former Name | KATHERINE ROSE LICHTBLAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 11569185-2506) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10907) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2020-01-23 |