NPI | 1528515434 |
---|---|
Former Name | KELLY ANNE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C6923) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R-6443) |
104100000X Social Worker | |
Enumeration Date | 2016-09-08 |
Last Update Date | 2023-12-27 |