| NPI | 1740811165 |
|---|---|
| Former Name | KELSEY GLEASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401017380) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401017380) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2024-08-13 |