NPI | 1760818918 |
---|---|
Former Name | KIMBERLY ROSE BRUNELLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA CG60354315) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60354315) |
Enumeration Date | 2013-09-19 |
Last Update Date | 2013-09-19 |