| NPI | 1326121757 |
|---|---|
| Former Name | KIMBERLY JEAN SCHULTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: SD LPC-MH2155) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH2155) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2024-04-25 |