| NPI | 1518326537 |
|---|---|
| Former Name | KIMBERLEE K DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-05-08) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 23-QMHA-R-3600) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2023-09-28 |