| NPI | 1689224800 | 
|---|---|
| Former Name | KIAYA A DEMONBREUN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 8374) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 7165) | 
| 101YP2500X Counselor, Professional (Licence: SC 7165) | |
| Enumeration Date | 2019-09-19 | 
| Last Update Date | 2024-11-18 |