| NPI | 1952550808 |
|---|---|
| Former Name | KIMBERLY ANN MICHAEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 004805) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 004805) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2024-08-16 |