| NPI | 1699877043 |
|---|---|
| Former Name | CANDICE RAE KVISTAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN LPC0000004941) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH6645) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2024-09-17 |