Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 5609 | OH |
Y | 103TC0700X | Clinical Psychologist | 5609 | OH |
N | 103TH0004X | Health Psychologist | 5609 | OH |
N | 103TP2701X | Group Psychotherapist | 5609 | OH |
NPI | 1568971455 |
---|---|
Provider Name | Dr. Kirsten Harrell |
First Address | Centerville, OH 45459-6209 |
Second Address | Centerville, OH 45459-6209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2017 |
Last Update Date | 24/09/2017 |