NPI | 1386777902 |
---|---|
Former Name | KRISTIN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 2772) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY7350) |
103TC0700X Psychologist, Clinical (Licence: TN P2772) | |
Enumeration Date | 2007-03-13 |
Last Update Date | 2007-07-08 |