| NPI | 1255791802 |
|---|---|
| Former Name | KIM A WISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: LA PLC9874) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2024-12-09 |