| NPI | 1386312783 |
|---|---|
| Other Name | KIKI SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 16183) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-20-142531) |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2024-04-26 |