NPI | 1053721274 |
---|---|
Former Name | KRISTINA MADIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC5151) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
101YP2500X Counselor, Professional (Licence: NJ 37PC00471100) | |
101YP2500X Counselor, Professional (Licence: AZ LPC-5489T) | |
Enumeration Date | 2014-04-28 |
Last Update Date | 2020-01-06 |