| NPI | 1639279318 |
|---|---|
| Professional Name | CONNIE J KERSENBROCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 7405) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 3576) |
| 1041C0700X Social Worker, Clinical (Licence: KS 3576) | |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2018-01-12 |