| NPI | 1043485337 |
|---|---|
| Former Name | KELLI LEA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2875) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 00982) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2023-09-26 |