| NPI | 1588036362 |
|---|---|
| Former Name | MCKENZIE BOLTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A11790) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 11790) |
| 101YP2500X Counselor, Professional (Licence: NC 11790) | |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2022-01-14 |