| NPI | 1780884304 |
|---|---|
| Former Name | HEATHER CREGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008450) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071008450) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-21 |
| Last Update Date | 2024-07-11 |