NPI | 1982107181 |
---|---|
Former Name | KIMBERLY KAY BURTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 29954) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 29954) |
Enumeration Date | 2018-03-14 |
Last Update Date | 2024-02-21 |