NPI | 1699278911 |
---|---|
Former Name | DANIELLE BERTHA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD 14308) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 2221) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 15-117) | |
Enumeration Date | 2018-03-13 |
Last Update Date | 2023-12-04 |