| NPI | 1104564277 |
|---|---|
| Former Name | SAVANNAH LEEANN FISK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-10-03 |