| NPI | 1114312741 |
|---|---|
| Former Name | KATHRYN ELIZABETH CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC13948) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC 15366) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2018-06-08 |