| NPI | 1033500467 |
|---|---|
| Former Name | SHEA KOEHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KS 2684) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 2629) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2019-03-14 |