NPI | 1447901814 |
---|---|
Former Name | KRISTEL GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00551900) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00551900) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 37PC00551900) | |
Enumeration Date | 2022-01-17 |
Last Update Date | 2022-01-17 |