| NPI | 1700017829 |
|---|---|
| Former Name | ELIZABETH A MONGILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 003111) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 9381) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2014-02-21 |