| NPI | 1770441644 |
|---|---|
| Former Name | TAIJA PARKER |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 149.0133964) |
| Enumeration Date | 2026-01-12 |
| Last Update Date | 2026-01-21 |