NPI | 1710537758 |
---|---|
Former Name | KAREN ROTHBALLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CT 3871) |
Additional Taxonomies | 103T00000X Psychologist |
Enumeration Date | 2019-09-11 |
Last Update Date | 2019-09-16 |