| NPI | 1376791970 |
|---|---|
| Former Name | KELLIE RENE MOYERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 18591) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 18591) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2010-01-08 |