NPI | 1154671972 |
---|---|
Former Name | KYRA KAMILLE BRADLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401019513) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401011094) |
Enumeration Date | 2012-09-19 |
Last Update Date | 2022-10-14 |