| NPI | 1972860260 |
|---|---|
| Former Name | KELLI MICHELLE SLEETH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101260419) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2016-09-08 |