| NPI | 1588074827 |
|---|---|
| Former Name | KELLEY LAVERNE LUTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.011629) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180011629) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2023-07-15 |