NPI | 1801190624 |
---|---|
Former Name | KIMBERLY CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-004017) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4017) |
103TP2701X Psychologist, Group Psychotherapy | |
103TB0200X Psychologist, Cognitive & Behavioral | |
Enumeration Date | 2011-01-08 |
Last Update Date | 2021-01-14 |