NPI | 1952535312 |
---|---|
Former Name | KRISTIN EVELYN WEIMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180008172) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180008172) |
101Y00000X Counselor (Licence: IL 178005884) | |
Enumeration Date | 2009-05-13 |
Last Update Date | 2019-03-01 |