| NPI | 1497156228 |
|---|---|
| Former Name | KELLY VANDERMOLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801091029) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801091029) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2022-06-01 |