| NPI | 1851873046 |
|---|---|
| Former Name | CARISSA ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ND 569) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2019-04-30 |