Individual
KYLEE J GORDLEY-SHURTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
NM00561
NM
101YP2500X
Professional Counselor
Primary
NM005691
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G2229
—
NM
05
—
NM600501
—
NM
Enumeration date
07/13/2005
Last updated
04/08/2008
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