| NPI | 1891923645 |
|---|---|
| Former Name | KELLY K KOUKOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35SI00468300) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS016490) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2014-11-07 |