| NPI | 1609169291 |
|---|---|
| Former Name | KRISTIN CAROL THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MT PSY-REG-0001330) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4187) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2021-05-28 |