| NPI | 1972159762 |
|---|---|
| Former Name | REBECCA SUZANNE KILOUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701009791) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2020-08-28 |