NPI | 1477685220 |
---|---|
Former Name | KIMBERLY STANLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 35970) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 47059) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2025-07-08 |