| NPI | 1609680636 |
|---|---|
| Former Name | BETHANY KIMBLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701012578) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701012578) |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-01-31 |