NPI | 1376809897 |
---|---|
Former Name | HALEY A PORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 4658-125) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15739-131) |
101YM0800X Counselor Mental Health (Licence: WI 4658-125) | |
Enumeration Date | 2012-04-10 |
Last Update Date | 2019-02-05 |