| NPI | 1609684034 |
|---|---|
| Former Name | KELLY L BURTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD PC016220) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC016220) |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2025-03-25 |