| NPI | 1194268623 |
|---|---|
| Former Name | AVERY ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR 22-QMHP-R-1292) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 17331) |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2022-06-28 |