| NPI | 1043502685 |
|---|---|
| Former Name | KELLI DAWN GEORGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E.1800918) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH C0008147) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2018-11-01 |