| NPI | 1083246128 |
|---|---|
| Former Name | KAITLYN HANCOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2024-01-23 |