NPI | 1255492799 |
---|---|
Former Name | KAREN LEE LONDRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2328-57) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 2328057) |
103TC0700X Psychologist, Clinical (Licence: MN LP5638) | |
Enumeration Date | 2006-12-12 |
Last Update Date | 2015-03-20 |