| NPI | 1114091469 |
|---|---|
| Former Name | KANEY JERVELLE CRUMP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 054710) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A97005) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |