NPI | 1215463047 |
---|---|
Former Name | KIMBERLY KOOPMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-05-11 |
Last Update Date | 2023-11-03 |