| NPI | 1558757500 |
|---|---|
| Former Name | KENDRA ROSAMOND DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 10831) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2018-08-30 |