NPI | 1902235575 |
---|---|
Former Name | KIMBERLY KHADOO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 243316) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 243316) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2013-11-04 |
Last Update Date | 2024-04-30 |