NPI | 1316160427 |
---|---|
Former Name | DANIELLE LYNN BEDELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KS 04-37833) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2010007579) | |
Enumeration Date | 2007-04-10 |
Last Update Date | 2015-10-08 |