NPI | 1013554054 |
---|---|
Former Name | KRISSA L COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DE PC-0011189) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00702400) |
Enumeration Date | 2019-12-10 |
Last Update Date | 2024-12-18 |