| NPI | 1962798744 |
|---|---|
| Former Name | KAYLYN MCKELVEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 13-12-27) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2015-01-02 |