| NPI | 1730686502 |
|---|---|
| Former Name | KRYSTA CARLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 4839) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 174400000X Specialist | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2024-11-12 |