NPI | 1881262863 |
---|---|
Former Name | STEPHANIE BORJAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071010393) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017737) |
103TS0200X Psychologist, School (Licence: IL 2384697) | |
Enumeration Date | 2021-06-15 |
Last Update Date | 2022-08-31 |