| NPI | 1730832916 |
|---|---|
| Former Name | AMANDA EILEEN KERNS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 16182) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC A16182) |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2023-04-20 |