| NPI | 1225770928 |
|---|---|
| Former Name | BROOKE KENNEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NH 2828) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VT 097.0135286) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2024-03-11 |