NPI | 1700202272 |
---|---|
Former Name | KRISTINA WATT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 104177) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY KY0572) |
Enumeration Date | 2014-03-08 |
Last Update Date | 2019-07-15 |