| NPI | 1639569395 |
|---|---|
| Former Name | KRISTIE ANN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C016733) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2022015605) |
| 1041C0700X Social Worker, Clinical (Licence: HI 4806) | |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904014884) | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2025-10-02 |