|Taxonomy Code||Specialty Code||Provider Type|
|1041C0700X||80||Licensed Clinical Social Worker|
|LBN Legal business name||KENAITZE INDIAN TRIBE|
|DBA Doing business as||NAKENU FAMILY CENTER|
|Authorized official||JENNIFER YEOMAN - (HUMAN SRVS DIRECTOR)|
|Organization subpart 1||Not specified|
|Last updated||07/09/2007 - About 9 years ago|
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