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Individual
MISS MOON PRAYER RAINBOW
Active
Individual
MISS MOON PRAYER RAINBOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CL 60491288
WA
106S00000X
Behavior Technician
Primary
CB61056109
WA
Other
Enumeration date
01/28/2015
Last updated
04/03/2020
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