| NPI | 1043083801 |
|---|---|
| Former Name | SHELLI RAE RIDENER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 272705) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 272705) |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2023-11-03 |