NPI | 1952953523 |
---|---|
Former Name | JILL BETH ROMANSKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04555) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 04555) |
Enumeration Date | 2019-07-12 |
Last Update Date | 2019-08-21 |