Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 3448 | AZ |
N | 103TC0700X | Clinical Psychologist | 3448 | AZ |
N | 103G00000X | Clinical Psychologist | 3448 | AZ |
N | 103TC0700X | Clinical Psychologist | 3448 | AZ |
N | 103TH0100X | Health Service | 3448 | AZ |
NPI | 1306943642 |
---|---|
Provider Name | Dr. Kathryn Chiesa Crema |
First Address | Prescott, AZ 86313-5001 |
Second Address | Prescott, AZ 86313-5001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |