NPI | 1265057475 |
---|---|
Former Name | JESSICA ANN DIVERSI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-20-42578) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-20-42578) |
Enumeration Date | 2020-06-12 |
Last Update Date | 2022-10-24 |