| NPI | 1326273426 |
|---|---|
| Former Name | DESIRAE ANGELA MCKENZIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 2287) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1341) |
| 103TC0700X Psychologist, Clinical (Licence: KS 2090) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2022-12-25 |