NPI | 1578112124 |
---|---|
Former Name | ERIN KELLE KENNEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401018598) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401016271) |
Enumeration Date | 2019-09-06 |
Last Update Date | 2020-09-03 |