NPI | 1033728357 |
---|---|
Former Name | SHENIKA BORDEAUX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1800) |
Additional Taxonomies | 106S00000X Behavior Technician |
171M00000X Case Manager/Care Coordinator | |
101YM0800X Counselor, Mental Health (Licence: MN 304585) | |
Enumeration Date | 2020-07-23 |
Last Update Date | 2023-09-13 |