NPI | 1457763146 |
---|---|
Former Name | KIMBERLY GOULD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2013044075) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2013044075) |
Enumeration Date | 2014-05-29 |
Last Update Date | 2023-10-11 |