| NPI | 1164987392 |
|---|---|
| Former Name | JACLENE ANNALIESE PEACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2020-06-11 |