| NPI | 1740596139 |
|---|---|
| Former Name | KELLY THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801090422) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801090422) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6801090422) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2024-02-28 |