NPI | 1568838407 |
---|---|
Former Name | KATHRYN SHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 13003) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 271) |
101YM0800X Counselor, Mental Health (Licence: NC A13003) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37AC00307300) | |
Enumeration Date | 2015-08-14 |
Last Update Date | 2024-11-05 |