| NPI | 1699965996 |
|---|---|
| Former Name | MINA M SANTORSOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 7269) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: OR 2127) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2015-03-23 |