| NPI | 1154483816 |
|---|---|
| Former Name | KIMBERLY MICHELLE DIRKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC52717) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 106H00000X Marriage & Family Therapist (Licence: CA 54218) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-09-01 |