| NPI | 1619522232 |
|---|---|
| Former Name | RYLEE BUNTEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 13359503-6018) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: UT RBT-19-90465) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2023-06-29 |