| NPI | 1063080356 |
|---|---|
| Former Name | KIMBERLY FAYE BROOKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61192980) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-07-21 |