NPI | 1225117856 |
---|---|
Former Name | KATHLEEN MAXFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MT 0153) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM LPCC4780) |
Enumeration Date | 2006-11-03 |
Last Update Date | 2025-09-11 |