| NPI | 1134604010 |
|---|---|
| Former Name | MISTY MICHELE SHEPPARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 1050) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: CA F2306223) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2022-10-19 |