NPI | 1063551166 |
---|---|
Former Name | KRISTINE SHARDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3823) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-2390) |
Enumeration Date | 2007-02-05 |
Last Update Date | 2009-06-01 |