NPI | 1326404765 |
---|---|
Former Name | KIMBER LAUREN CHORAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 269513) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2016-01-14 |
Last Update Date | 2024-08-15 |