| NPI | 1093938839 |
|---|---|
| Former Name | KELLY L BACKHAUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WY LMFT -139) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 62396) |
| 101YP2500X Counselor, Professional (Licence: WY LPC - 1073) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 201042) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2011-10-21 |