| NPI | 1134558463 |
|---|---|
| Former Name | KRISTINE ELIZABETH WILMOTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014161) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014161) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2024-11-27 |