| NPI | 1750922746 |
|---|---|
| Former Name | JEZAIAH VALENCIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C9125) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2024-11-18 |