NPI | 1114407897 |
---|---|
Former Name | LISA M SWEERE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304301) |
101YP2500X Counselor, Professional (Licence: MN 2281) | |
Enumeration Date | 2018-08-21 |
Last Update Date | 2021-01-29 |