NPI | 1972056422 |
---|---|
Former Name | KRISTAN MARIE INMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 14417) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC RBT-15-03491) |
Enumeration Date | 2016-08-02 |
Last Update Date | 2024-06-05 |