| NPI | 1558974873 |
|---|---|
| Former Name | KELLY ANDRESEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010600) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL Postdoc) |
| 103TH0004X Psychologist, Health | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2021-10-12 |