| NPI | 1811327034 |
|---|---|
| Former Name | LAURA ELIZABETH CHESSLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071.008767) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.008767) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS LP2175) | |
| 103TC0700X Psychologist, Clinical (Licence: KS LP2175) | |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2020-01-25 |