NPI | 1194940486 |
---|---|
Former Name | KIMBERLY ANNE BRECKENRIDGE/KREAMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ID LCPC-4251) |
Enumeration Date | 2007-04-13 |
Last Update Date | 2024-09-17 |