NPI | 1619308772 |
---|---|
Former Name | KRISTEN YERDONEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9778) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071008232) |
Enumeration Date | 2013-11-27 |
Last Update Date | 2013-11-27 |