| NPI | 1619538196 |
|---|---|
| Former Name | KARA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 9060) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YM0800X Counselor, Mental Health (Licence: SC 9060) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2024-03-06 |