NPI | 1073984266 |
---|---|
Professional Name | KIM WISE GASTINELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 47-5122250) |
Enumeration Date | 2015-10-13 |
Last Update Date | 2022-03-24 |