| NPI | 1932452745 |
|---|---|
| Former Name | KATIE L RODAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: DE B1-0000926) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS017810) |
| 103TC0700X Psychologist, Clinical (Licence: PA PS017810) | |
| 103TC0700X Psychologist, Clinical (Licence: DE B1-0000926) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DE B100000926) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017810) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: DE b100000926) | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2022-04-01 |