| NPI | 1538645593 |
|---|---|
| Former Name | KATHRYN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701011342) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC8519) |
| 1041C0700X Social Worker, Clinical (Licence: MD LC8519) | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2023-09-25 |