NPI | 1598015786 |
---|---|
Former Name | KATHLEEN ALICE JOACHIM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6004) |
Additional Taxonomies | 103T00000X Psychologist |
Enumeration Date | 2012-09-14 |
Last Update Date | 2016-09-01 |