NPI | 1114686268 |
---|---|
Former Name | KRIS ANNE KILLAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 10659) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
101Y00000X Counselor | |
Enumeration Date | 2021-12-15 |
Last Update Date | 2021-12-15 |