NPI | 1104436559 |
---|---|
Doing Business As | AEVI INTEROCEPTIVE WELLNESS |
Entity Type | Organization |
Authorized Contact | ANDREA D HANSON Owner And Therapist 385-355-4505 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
101YP2500X Counselor, Professional | |
Enumeration Date | 2020-07-31 |
Last Update Date | 2020-07-31 |