| NPI | 1174015143 |
|---|---|
| Former Name | ELIZABETH ROSE MAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NV 6009) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 11507) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-07-06 |