| NPI | 1215527213 |
|---|---|
| Former Name | HANNAH QUINN RIVENBURGH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR C6010) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: OR ART-T-10209883) |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2024-08-09 |