NPI | 1932129517 |
---|---|
Former Name | CHRISTINE ASHLEY KISTLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005807) |
Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810005807) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2023-11-02 |