NPI | 1114339488 |
---|---|
Former Name | AYSHA MAE CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-15-18610) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2014-05-21 |
Last Update Date | 2019-02-12 |