NPI | 1962262048 |
---|---|
Former Name | LEAH LATTERNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CT 8.005140) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2024-03-19 |
Last Update Date | 2025-09-02 |