| NPI | 1528466034 |
|---|---|
| Former Name | KIMBERLY RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 3606) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA PCCI # 1636) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2024-10-15 |