NPI | 1467771782 |
---|---|
Former Name | KELLY ANN SOLAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180014621) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 005800-1) |
101YM0800X Counselor, Mental Health (Licence: VA 0701004794) | |
Enumeration Date | 2010-05-26 |
Last Update Date | 2022-09-19 |