| NPI | 1164403085 |
|---|---|
| Other Name | KELLE AUDREY WATSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005236) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701005236) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2024-11-04 |