| NPI | 1558678508 |
|---|---|
| Former Name | MEGAN KATHLEEN NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.009116) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2015-08-14 |