| NPI | 1326447897 |
|---|---|
| Former Name | KIMBERLY MAHON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 97888) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09923587) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2021-10-07 |