| NPI | 1447667878 |
|---|---|
| Former Name | KRISTINA BETH KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 0071611) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P93595) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2017-03-28 |