| NPI | 1942001987 |
|---|---|
| Former Name | KELLY R ALLSUP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2025050264) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2023046499) |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-11-28 |