| NPI | 1083747224 |
|---|---|
| Former Name | KIMBERLY ANNE PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 398) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 3706S) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2014-10-22 |