NPI | 1750050712 |
---|---|
Former Name | KAELIN CLOGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC018080) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2021-09-12 |
Last Update Date | 2025-04-18 |