| NPI | 1699940783 |
|---|---|
| Former Name | ELIZABETH ELLEN PARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NH 1576) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS016192) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2022-08-19 |