| NPI | 1003463589 |
|---|---|
| Former Name | AMANDA MCKELVEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 8638) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4335) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2022-07-18 |