NPI | 1194114389 |
---|---|
Former Name | JANA RICHERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2811) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-02-05) |
Enumeration Date | 2015-01-12 |
Last Update Date | 2023-11-09 |