| NPI | 1598911679 |
|---|---|
| Former Name | LESLIE ANNE KJOSA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 8871) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MA 8871) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2008-08-08 |