| NPI | 1588990022 |
|---|---|
| Former Name | KELLI DEERINWATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 4550) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 4550) |
| Enumeration Date | 2009-10-18 |
| Last Update Date | 2020-04-20 |