| NPI | 1730661943 |
|---|---|
| Other Name | KATRINA AGNEAUELLE GARY-FORTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12529) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2022-07-01 |