| NPI | 1891420360 |
|---|---|
| Former Name | JACQUELINE PATRICIA KELK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NH 713) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VT 097.0135345) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2024-08-06 |