| NPI | 1568498806 | 
|---|---|
| Former Name | KRISHNA PORTER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-12462) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC - 11673) | 
| Enumeration Date | 2006-06-25 | 
| Last Update Date | 2025-03-18 |