| NPI | 1972352490 |
|---|---|
| Former Name | JAIRREN N KEOHLMOOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 4003) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 1429) |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-20 |