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 |