| NPI | 1053707372 |
|---|---|
| Former Name | MEGHANN ELISE KENNEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60779531) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2021-05-06 |