| NPI | 1174206130 |
|---|---|
| Former Name | SHAE LYNN RILEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0019966) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0000278) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |