| NPI | 1316455785 |
|---|---|
| Former Name | KELSEY MARIE DEVRIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: RI CSW03343) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 7339-R) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2023-07-11 |