| NPI | 1780132126 |
|---|---|
| Former Name | KRISTA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NE 982) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 37402) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2025-11-18 |