NPI | 1720477334 |
---|---|
Former Name | KATHERINE MARIE BELLONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 36990) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36990) |
Enumeration Date | 2015-01-20 |
Last Update Date | 2019-02-21 |