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Individual
KIM T LAHAISE
Active
Individual
KIM T LAHAISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
330
ND
103TP0814X
Psychoanalysis Psychologist
330
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11096
—
ND
05
—
689480100
—
MN
Enumeration date
07/17/2006
Last updated
02/07/2025
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