NPI | 1467970111 |
---|---|
Former Name | CHELSEA KALYNN KOCIUBA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OH P.07727) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH P.07727) |
Enumeration Date | 2017-09-01 |
Last Update Date | 2018-06-19 |