NPI | 1952694283 |
---|---|
Former Name | TERRA LYNN KERN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.016752) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-05-19 |
Last Update Date | 2016-10-28 |