NPI | 1275199465 |
---|---|
Other Name | KIMBERLY KAYANA BRYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LGP10877) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2019-05-14 |
Last Update Date | 2021-01-19 |