| NPI | 1952736431 |
|---|---|
| Former Name | ELIZABETH ANNE GRAVALLESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS019243) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35SI00574600) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2024-05-29 |