NPI | 1275638769 |
---|---|
Former Name | CAROL GRAY KENNEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC15858ME) |
Additional Taxonomies | 103T00000X Psychologist (Licence: ME CC1858) |
Enumeration Date | 2006-09-13 |
Last Update Date | 2016-11-09 |