NPI | 1154035855 |
---|---|
Former Name | CARLEE CHURCHEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: WA CG61509360) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2023-01-09 |
Last Update Date | 2023-12-11 |