| NPI | 1205232865 |
|---|---|
| Former Name | KRISTEN MICHELLE CARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NE 900) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 4596) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2016-09-26 |