| NPI | 1679566368 |
|---|---|
| Former Name | KATHLEEN KAY DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 1757) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 772) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2024-02-02 |