| NPI | 1033611181 |
|---|---|
| Former Name | MICHAEL RYAN DIVINE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TN RBT-16-17545) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2026-07-23 |