| NPI | 1851911127 |
|---|---|
| Former Name | KAITLYN NITSCHE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180015246) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178014535) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2023-12-06 |