| NPI | 1841659265 |
|---|---|
| Former Name | KIMBERLY SHORTS-JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2017-09-06 |