| NPI | 1902190614 |
|---|---|
| Former Name | KIMBERLY HAAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5193) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2024-01-17 |