| NPI | 1104179647 |
|---|---|
| Former Name | KIRSTEN JANE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.00001738) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000199) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2019-05-31 |