| NPI | 1285209791 |
|---|---|
| Former Name | KIRSTEN MARY ELISE BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OK 1442) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 12591) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-09-30 |