NPI | 1790109064 |
---|---|
Former Name | KATHRYN SPORING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C7415) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R6392) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A00582) | |
Enumeration Date | 2014-02-07 |
Last Update Date | 2024-01-10 |