NPI | 1558938225 |
---|---|
Former Name | AMANDA OLLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSB94027351) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 94027351) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 101YA0400X) | |
Enumeration Date | 2021-06-09 |
Last Update Date | 2024-08-21 |