NPI | 1912555129 |
---|---|
Former Name | ALICIA LINERUD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61416907) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG61416907) |
106S00000X Behavior Technician | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-08-30 |
Last Update Date | 2024-03-27 |