NPI | 1376041020 |
---|---|
Former Name | RACHAEL GIACCONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22722) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 15203) |
Enumeration Date | 2018-01-29 |
Last Update Date | 2024-09-24 |