| NPI | 1871361865 |
|---|---|
| Former Name | SHAYNA NICOLE BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA sw138792) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA sw138792) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA sw138792) | |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2023-12-19 |