| NPI | 1023197571 |
|---|---|
| Former Name | KELLY JEAN HOAGLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 54814-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 224956) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2025-01-03 |