| NPI | 1194207142 |
|---|---|
| Former Name | STEPHANIE GANA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 5394) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 1288) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2020-12-22 |