NPI | 1235430802 |
---|---|
Former Name | KELSY D ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101006471) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2010-11-12 |
Last Update Date | 2025-03-05 |