| NPI | 1467605253 |
|---|---|
| Former Name | KIMBERLY LYNN CARPENTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH60878512) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP60878159) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD.0000438) | |
| 101YP2500X Counselor Professional (Licence: CO LPC.0005023) | |
| 101YP2500X Counselor Professional (Licence: CO 5023) | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2018-11-12 |