| NPI | 1508312794 |
|---|---|
| Former Name | KRISTEN NICOLE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401015291) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-10-14 |