| NPI | 1548413727 |
|---|---|
| Former Name | JAMIE KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2008032467) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CA 10800) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2023-01-26 |