| NPI | 1386838225 |
|---|---|
| Former Name | KELLY MARIE SHAUGHNESSY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008933) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2016-02-23 |