| NPI | 1821650664 |
|---|---|
| Former Name | EMILY I ANDERBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 11608) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2021-10-19 |