NPI | 1053667352 |
---|---|
Former Name | KRISTAL RENEE BAISCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-14-15662) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 01-12-5088) |
Enumeration Date | 2012-07-24 |
Last Update Date | 2024-07-21 |