NPI | 1477109247 |
---|---|
Former Name | JESSICA LEIGH KELLIHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 1587) |
Additional Taxonomies | 103T00000X Psychologist |
Enumeration Date | 2019-08-16 |
Last Update Date | 2019-10-18 |