NPI | 1588037774 |
---|---|
Former Name | KYRA M LOGSDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0105944) |
Enumeration Date | 2015-11-10 |
Last Update Date | 2025-04-11 |