| NPI | 1710009774 |
|---|---|
| Former Name | SHAYLA ANN SULLIVANT DEHAEMERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MO 2010028299) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KS 9406387) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2010-10-05 |