NPI | 1205233764 |
---|---|
Former Name | KRISTEN JEANETTE KENNARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401018571) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401014563) |
Enumeration Date | 2014-11-29 |
Last Update Date | 2025-05-08 |