| NPI | 1982190310 |
|---|---|
| Former Name | KELLY ANN REGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA PY61107819) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2023-09-01 |