NPI | 1427529841 |
---|---|
Former Name | KIMBERLY KNOX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE 0000102) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DE 0000102) |
104100000X Social Worker (Licence: DE q3-0000250) | |
Enumeration Date | 2018-12-11 |
Last Update Date | 2020-04-14 |