| NPI | 1669881348 |
|---|---|
| Former Name | LISA KRISTINE TANKERSLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60628904) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 2538) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2018-10-17 |