| NPI | 1912518051 |
|---|---|
| Former Name | KIMBERLY DRAGON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15361) |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2022-08-15 |