| NPI | 1255052619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER CONNOR Behavioral Intervention Aide 614-312-6434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |