NPI | 1043502685 |
---|---|
Former Name | KELLI DAWN GEORGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
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 |