NPI | 1518315134 |
---|---|
Former Name | SARA KINGSBURY-DOLAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00532500) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2016-05-25 |
Last Update Date | 2018-11-09 |