| NPI | 1871176685 |
|---|---|
| Former Name | KELSEY ELIZABETH AMMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OR 21-QMHA-R-1125) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: OR 67061) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |