NPI | 1720170558 |
---|---|
Former Name | GLORIA MANSOUR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy |
Enumeration Date | 2006-09-29 |
Last Update Date | 2014-05-23 |