| NPI | 1407547144 |
|---|---|
| Former Name | JAMIE LYNN AHNBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KY 129098) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 129098) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-07-14 |