| NPI | 1568898393 |
|---|---|
| Former Name | KIMBERLY YVETTE WILLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 57087) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 57087) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2025-01-27 |