| NPI | 1285915538 |
|---|---|
| Former Name | ERICA STEPHANIE SEVERTSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 2639) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KS 1-08-4514) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2020-11-25 |