| NPI | 1295034643 |
|---|---|
| Former Name | KELLY ANNE BROGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4966) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2022-12-15 |