NPI | 1376056473 |
---|---|
Former Name | KRISTIN MCBRIDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-10344) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-10344) |
Enumeration Date | 2017-11-10 |
Last Update Date | 2023-01-20 |