NPI | 1558422923 |
---|---|
Former Name | KRISTINE JOHNSTON GERWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 228590) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: TX 228590) |
Enumeration Date | 2006-12-12 |
Last Update Date | 2019-10-01 |