| NPI | 1003398579 |
|---|---|
| Former Name | LACEY RENEE BRUNT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2022-06-27 |