NPI | 1972964773 |
---|---|
Former Name | SHARON GROB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 71.004209) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 71.004209) |
Enumeration Date | 2016-03-08 |
Last Update Date | 2021-03-10 |