NPI | 1255791802 |
---|---|
Former Name | KIM A WISE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: LA PLC9874) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2016-02-24 |
Last Update Date | 2023-11-06 |