| NPI | 1841605300 |
|---|---|
| Former Name | KIMBERLY DENISE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2015-12-14 |