| NPI | 1285929984 |
|---|---|
| Former Name | KRISTEN KERRY NIEDERER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 5451) |
| Additional Taxonomies | 225600000X Dance Therapist (Licence: CA 1267) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2022-11-22 |