NPI | 1386129823 |
---|---|
Former Name | KELSEY LOGDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 283588) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2018-10-01 |
Last Update Date | 2024-02-19 |