| NPI | 1124481312 |
|---|---|
| Former Name | MARY KATHLEEN KIBORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180010634) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2014044614) |
| 101YP2500X Counselor, Professional (Licence: IL 180010634) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2024-10-31 |