NPI | 1841073327 |
---|---|
Former Name | LAUREN FERN QUAST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY004723) |
Enumeration Date | 2023-08-17 |
Last Update Date | 2024-01-10 |