| NPI | 1023614088 |
|---|---|
| Former Name | KATRINA REARDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC13430) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 20041) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2023-12-15 |