NPI | 1093730632 |
---|---|
Former Name | THERESA ELISE MCCARTHY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YP2500X Counselor, Professional (Licence: SC 3750) | |
Enumeration Date | 2006-07-13 |
Last Update Date | 2024-03-21 |