NPI | 1326371147 |
---|---|
Former Name | KRISTY LYNNE BORDSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN 00011) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 00011) |
101YP2500X Counselor, Professional (Licence: MN cc00011) | |
Enumeration Date | 2009-09-11 |
Last Update Date | 2018-03-17 |