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 |