| NPI | 1841648540 |
|---|---|
| Former Name | KRYSTAL JUDAH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 10729-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 10729-125) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2024-12-30 |