NPI | 1235298316 |
---|---|
Former Name | KYRA DAWN WARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: UT 6071470-6004) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LPC-3728) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2011-01-14 |