| 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 |