NPI | 1891742540 |
---|---|
Former Name | KATHLEEN KEELY MCCANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ID PSY202777) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MO 2003023860) |
Enumeration Date | 2006-05-28 |
Last Update Date | 2014-02-21 |