NPI | 1861731986 |
---|---|
Former Name | TERESA WREN JOHNSTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006067) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA 0006067) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 0006067) | |
Enumeration Date | 2013-02-08 |
Last Update Date | 2024-04-16 |