| NPI | 1790016392 |
|---|---|
| Former Name | KIMBERLY DAWN HARRISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20042475A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20042475A) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2024-03-28 |