NPI | 1235357146 |
---|---|
Former Name | KRISTINA JOYCE COBB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY 102103) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY 1279) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2018-04-26 |