| NPI | 1679923049 |
|---|---|
| Former Name | KIMBERLY ANNE KERSENBROCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE LMHP448) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE LPC372) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |