| NPI | 1720688278 |
|---|---|
| Former Name | KIMBERLY WALLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH M.2000185-TRNE) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2002358-TRNE) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-26 |