NPI | 1891209599 |
---|---|
Former Name | KAELYN MARIE RIBARY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60878508) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60336491) |
Enumeration Date | 2017-11-17 |
Last Update Date | 2022-03-03 |