NPI | 1801235213 |
---|---|
Former Name | KAREN THOUSAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 5572) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN Lp5572) |
Enumeration Date | 2013-06-19 |
Last Update Date | 2018-07-12 |