| NPI | 1538537022 |
|---|---|
| Former Name | KIMBERLY BURDETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA PSY31168) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2019-08-27 |