NPI | 1104561034 |
---|---|
Former Name | LINDA MARIA KIMMONS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225A00000X Music Therapist (Licence: GA MUT000039) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA LPC011681) |
Enumeration Date | 2022-05-04 |
Last Update Date | 2022-05-04 |