| NPI | 1548843121 |
|---|---|
| Professional Name | PHOENIX WELLNESS LLC DBS CICELY HOLSTON COUNSELING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC016640) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2024-12-30 |