| NPI | 1720413487 |
|---|---|
| Former Name | KELYSEY ALINA SCHROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC009062) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 90574) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2017-04-21 |