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 | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2021-05-03 |
Last Update Date | 2024-06-25 |