| NPI | 1568028850 |
|---|---|
| Former Name | GRACE LEEBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61115510) |
| 106S00000X Behavior Technician | |
| 376K00000X Nurse's Aide (Licence: WA NA60411306) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG61115510) | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2022-11-29 |