NPI | 1427263243 |
---|---|
Former Name | KAREN LOUISE MCCOLLOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5312) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 2206) |
103TC0700X Psychologist, Clinical (Licence: MN LP5312) | |
Enumeration Date | 2007-05-14 |
Last Update Date | 2021-05-28 |