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 |