NPI | 1346966116 |
---|---|
Former Name | KAYLEN SHANEI RODRIGUEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2022038977) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY12175) |
103TC0700X Psychologist, Clinical (Licence: NY 026616) | |
Enumeration Date | 2022-10-13 |
Last Update Date | 2025-08-13 |