| NPI | 1952705022 |
|---|---|
| Former Name | KARISSA ANN BURGESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11534) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY61182843) |
| 103T00000X Psychologist (Licence: CA PSY33448) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2022-07-03 |