NPI | 1023600582 |
---|---|
Former Name | SHAYNA KEARN COFFIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LMFT-7650) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 11816) |
101YP2500X Counselor, Professional (Licence: ID LMFT-7650) | |
106H00000X Marriage & Family Therapist (Licence: ID LMFT-7650) | |
Enumeration Date | 2021-02-06 |
Last Update Date | 2024-02-12 |