| NPI | 1861849911 |
|---|---|
| Former Name | CARMEN GALLEGOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071010944) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2023-08-03 |