| NPI | 1104469360 |
|---|---|
| Former Name | KELSEY BOHNERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9815) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 130958-121) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2023-02-08 |