NPI | 1275710667 |
---|---|
Other Name | KENYATTA WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC007401) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC007401) |
Enumeration Date | 2008-01-28 |
Last Update Date | 2021-12-29 |