NPI | 1154625101 |
---|---|
Former Name | CAROLINA ANNA KELLENBERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 009908) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 1266) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1220) | |
101YM0800X Counselor, Mental Health (Licence: NE 4216) | |
Enumeration Date | 2011-01-05 |
Last Update Date | 2021-12-02 |