| NPI | 1316485113 |
|---|---|
| Former Name | KIMBERLY A WIATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-011365) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 32366) |
| 101YM0800X Counselor, Mental Health (Licence: IL 149.011365) | |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2021-04-26 |