| NPI | 1649024092 |
|---|---|
| Former Name | LIESL KINGSBURY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 221700000X Art Therapist |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-04-12 |