NPI | 1881028603 |
---|---|
Former Name | KRISTEN COCKSHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009177) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2013-08-28 |
Last Update Date | 2016-07-20 |