| NPI | 1053066423 |
|---|---|
| Former Name | MARIAH GAVANO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701013052) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0704014637) |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2026-08-06 |