NPI | 1013217124 |
---|---|
Former Name | COURTNEY LYNN ROSE NEWSOME |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-23-65049) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106S00000X Behavior Technician (Licence: GA RBT-20-141298) | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2010-10-25 |
Last Update Date | 2025-08-29 |