NPI | 1104007269 |
---|---|
Other Name | RICKY D BOEHM |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00005696) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA MAC501835) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00002340) | |
Enumeration Date | 2007-11-16 |
Last Update Date | 2025-04-16 |