| NPI | 1316671928 |
|---|---|
| Former Name | ERICA LYNN KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AL L252) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT001933) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2025-01-23 |