| NPI | 1386154805 |
|---|---|
| Former Name | KATRINA MARIE CZAJKOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 20310) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-10-05 |