| 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 |