| NPI | 1366907362 |
|---|---|
| Former Name | KELSEY LOUISE LUCKIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2024-07-10 |