| NPI | 1033511407 |
|---|---|
| Former Name | KELSEY LYNNE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 13-06-52) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2015-01-21 |