| NPI | 1780058651 |
|---|---|
| Former Name | KYLIE KATHLEEN POLZER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C011145) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-21771) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2018-03-17 |