| NPI | 1215251962 |
|---|---|
| Former Name | KEYONNA S WITHERSPOON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR A3534) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2020-08-12 |