NPI | 1114276730 |
---|---|
Former Name | KIMBERLY ROBERTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 274) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2003009071) |
Enumeration Date | 2012-08-29 |
Last Update Date | 2024-03-18 |