| NPI | 1508480732 |
|---|---|
| Former Name | KAYLA VANDENBUSCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 8381-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 4588-226) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2022-02-28 |