NPI | 1093373433 |
---|---|
Former Name | MARISSA DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VT 146.0123823) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VT 1-16-22388) |
Enumeration Date | 2019-05-31 |
Last Update Date | 2020-04-02 |