NPI | 1598269342 |
---|---|
Other Name | KEL CENGA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC.0021265) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-19-76595) |
Enumeration Date | 2018-03-19 |
Last Update Date | 2023-03-28 |