| NPI | 1730831140 |
|---|---|
| Former Name | KIMBERLY SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C7824) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C7824) |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2024-01-03 |