| NPI | 1891030557 |
|---|---|
| Former Name | KIMBERLY JUNE NYLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 079232) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: ID PSY - 202622) |
| 103TC0700X Psychologist Clinical (Licence: IL 071008632) | |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2015-10-15 |