NPI | 1184380347 |
---|---|
Former Name | KELSEA LYNN COLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851118225) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2021-11-11 |
Last Update Date | 2025-01-06 |