NPI | 1972755734 |
---|---|
Former Name | KRISTIN K POAGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60275222) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C2789) |
Enumeration Date | 2008-10-10 |
Last Update Date | 2013-08-26 |