| NPI | 1811029283 |
|---|---|
| Former Name | KEELY WATERS-KAKLAMANOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7401) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY7401) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY7401) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY7401) | |
| 103TC1900X Psychologist, Counseling (Licence: FL PY7401) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY7401) | |
| 103TE1100X Psychologist, Exercise & Sports (Licence: FL PY7401) | |
| 103TF0000X Psychologist, Family (Licence: FL PY7401) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2012-05-07 |