| NPI | 1689987158 |
|---|---|
| Former Name | SHELLY R INGWERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NE 850) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 9177) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2014-02-05 |