| 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 |