NPI | 1669413969 |
---|---|
Former Name | KIMBERLY JOY VAN HOUTEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012324) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301012324) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301012324) | |
Enumeration Date | 2006-06-09 |
Last Update Date | 2008-05-19 |