NPI | 1699967976 |
---|---|
Former Name | KRISTIN JOAN FLYNN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2009031637) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071006055) |
Enumeration Date | 2007-08-10 |
Last Update Date | 2010-02-03 |