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 |