| NPI | 1013559855 |
|---|---|
| Former Name | STEPHANIE L KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7442-125) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2020-10-14 |