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 |