NPI | 1083122766 |
---|---|
Former Name | KELSEY ERIN SIMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.009662) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.009662) |
Enumeration Date | 2018-01-17 |
Last Update Date | 2024-04-18 |