NPI | 1033991708 |
---|---|
Former Name | JENNY BAUTISTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LW61046958) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-23873) |
101YM0800X Counselor, Mental Health (Licence: NC C011928) | |
Enumeration Date | 2023-10-18 |
Last Update Date | 2024-08-20 |