NPI | 1679822332 |
---|---|
Former Name | LILA PEREIRA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 022617) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-09-09 |
Last Update Date | 2019-08-02 |