NPI | 1295159911 |
---|---|
Former Name | CHANDA M KELLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NV CP5102) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 21472) |
Enumeration Date | 2014-02-17 |
Last Update Date | 2024-01-27 |