| NPI | 1700124740 |
|---|---|
| Former Name | LAUREN MICHELLE BENNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9501) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TN P3070) |
| 103TC0700X Psychologist, Clinical (Licence: TN P3070) | |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2016-11-17 |