| NPI | 1992727036 |
|---|---|
| Former Name | ELLEN G VENNOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 002853) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 2853) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2022-09-09 |