NPI | 1790033348 |
---|---|
Former Name | COURTNEY KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3955) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 3955) |
Enumeration Date | 2012-08-29 |
Last Update Date | 2019-01-31 |