| NPI | 1003202052 |
|---|---|
| Former Name | KRISTEN DOUGHERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 010481) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 30427) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2020-05-29 |