NPI | 1710118054 |
---|---|
Former Name | KATHRYN ANNE WYMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP6151) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP6151) |
103TC0700X Psychologist Clinical (Licence: VA 0810005336) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-08-04 |
Last Update Date | 2023-07-18 |