NPI | 1366112682 |
---|---|
Former Name | CHAYLA A.M. DEWALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: WA 61225017) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61225017) |
Enumeration Date | 2021-09-17 |
Last Update Date | 2021-09-17 |