NPI | 1033150198 |
---|---|
Former Name | KRISTA K ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301010505) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301010515) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2022-11-21 |