NPI | 1356739551 |
---|---|
Professional Name | KIM MARIE DOUGLAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 811-12-1-14-296) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ND 811-12-1-14A) |
Enumeration Date | 2014-12-23 |
Last Update Date | 2021-10-27 |