NPI | 1780872374 |
---|---|
Former Name | CARISSA R NEHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IA 001204) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN LP5020) |
103T00000X Psychologist (Licence: IA 001204) | |
103TC0700X Psychologist, Clinical (Licence: MN LP5020) | |
Enumeration Date | 2007-10-09 |
Last Update Date | 2020-02-06 |