| NPI | 1477832749 |
|---|---|
| Former Name | JAMIE QUINN MAHONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0012465) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ADDC.0000312) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2023-10-24 |