NPI | 1003314907 |
---|---|
Former Name | KIERSTEN LYNETTE JABLONICKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 7631-25) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18178-130) |
Enumeration Date | 2018-01-25 |
Last Update Date | 2023-07-17 |