NPI | 1073805909 |
---|---|
Former Name | KASEY NICOLE MCCLAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60618364) |
Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60618364) |
103TC0700X Psychologist, Clinical (Licence: MO 2011019654) | |
Enumeration Date | 2011-05-11 |
Last Update Date | 2022-06-21 |