| NPI | 1720135395 |
|---|---|
| Former Name | KIMBERLY N BUCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3919) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC2912) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2011-07-20 |