| NPI | 1144764515 |
|---|---|
| Former Name | KARLYLE KELSEY CONNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-19997) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2019-07-31 |