| NPI | 1174371751 |
|---|---|
| Former Name | KIRA ROSE HARGRAVE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 39359) |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-06-26 |