| NPI | 1912053174 |
|---|---|
| Former Name | KRISTEN SARAH MCCLELLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012278) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc00084) |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2018-07-12 |