NPI | 1598323164 |
---|---|
Former Name | KELLEY ENSKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC11431) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP9575) |
Enumeration Date | 2019-05-30 |
Last Update Date | 2023-07-03 |