NPI | 1518046721 |
---|---|
Former Name | KRISTEN ANNETTE MANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: AL 2057G) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 2057G) |
Enumeration Date | 2006-11-06 |
Last Update Date | 2007-07-08 |