NPI | 1386192177 |
---|---|
Former Name | JENNIFER K ANDERSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY.0006727) |
Additional Taxonomies | 103K00000X Behavior Analyst |
103T00000X Psychologist (Licence: IL 071.009836) | |
103TC0700X Psychologist, Clinical (Licence: IL 071.009836) | |
Enumeration Date | 2016-09-21 |
Last Update Date | 2025-04-28 |