NPI | 1821427352 |
---|---|
Former Name | KRISTINA MARIE BUTLER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2013-11-05 |
Last Update Date | 2016-03-31 |