| NPI | 1659831600 |
|---|---|
| Former Name | DERICKA LEA KITTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 77911) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 77911) |
| 101YP2500X Counselor, Professional (Licence: TX 77911) | |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2021-03-31 |