NPI | 1487692133 |
---|---|
Former Name | KRISTEN GENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW015475) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA SW010075L) |
Enumeration Date | 2006-06-03 |
Last Update Date | 2015-10-05 |