NPI | 1104559095 |
---|---|
Former Name | BRIANA KINKEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401224517) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6451022257) |
Enumeration Date | 2022-07-07 |
Last Update Date | 2024-09-30 |