NPI | 1073021937 |
---|---|
Former Name | JAMIE LEE BEAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA 1073021937) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-16-16115) |
Enumeration Date | 2018-01-12 |
Last Update Date | 2023-02-07 |