NPI | 1972882967 |
---|---|
Former Name | HEATHER L CHRISTIANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 1277) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN 5377) |
Enumeration Date | 2011-08-09 |
Last Update Date | 2018-11-06 |