NPI | 1639726466 |
---|---|
Former Name | TRACEY ANN MCDOUGALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106S00000X Behavior Technician (Licence: WA CG61002191) | |
Enumeration Date | 2019-08-26 |
Last Update Date | 2023-07-07 |