NPI | 1174762884 |
---|---|
Former Name | KELLY AMANDA PAPROTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2008035918) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS LCPC2249) |
Enumeration Date | 2009-02-19 |
Last Update Date | 2012-10-09 |