| NPI | 1568498806 |
|---|---|
| Former Name | KRISHNA PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-12462) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC - 11673) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-07-08 |