| NPI | 1548912637 |
|---|---|
| Former Name | BRIANA SUZANNE MAHONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0012940) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000852) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-03-10 |