| NPI | 1770112997 |
|---|---|
| Former Name | KATHERINE PAMELA KOSTELECKY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NM CTL0220861) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-06-28 |