| NPI | 1831373794 |
|---|---|
| Former Name | BETHANY JANE SALLINEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013740) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301013740) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2020-12-17 |