| NPI | 1245606748 |
|---|---|
| Former Name | MICHAELA HOLLY PUTNAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5865) |
| Additional Taxonomies | 247200000X Technician, Other |
| 103K00000X Behavior Analyst (Licence: NC BACB360931) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2021-12-16 |