NPI | 1215257316 |
---|---|
Former Name | KIMBERLY DENISE CASTILE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 11473) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60704251) |
Enumeration Date | 2010-06-11 |
Last Update Date | 2022-04-20 |