| 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 |