| NPI | 1841744216 |
|---|---|
| Former Name | KELLY A. LOWY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 1249-124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18691-130) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2019-06-17 |