NPI | 1528695392 |
---|---|
Former Name | KATIE COGGESHALL CRIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1015740) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-23 |
Last Update Date | 2024-09-02 |