NPI | 1740447770 |
---|---|
Former Name | KELLY LORA HORRIGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: KS 1768) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2006034117) |
Enumeration Date | 2008-05-19 |
Last Update Date | 2017-11-14 |