Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MO | |
Y | 101YP2500X | Professional Counselor | MO | |
N | 101YP2500X | Professional Counselor | 20210153091 | MO |
N | 101YS0200X | School Counselor | MO |
NPI | 1124791843 |
---|---|
Provider Name | Kristin M Wilmes |
First Address | Saint Peters, MO 63376-7434 |
Second Address | Saint Peters, MO 63376-7434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2021 |
Last Update Date | 28/07/2021 |