| NPI | 1689821951 |
|---|---|
| Former Name | KELLY ANN CAPRON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 001585) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 8161) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2013-06-21 |