NPI | 1285918193 |
---|---|
Former Name | CANDICE M JOSTAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 01-07-3561) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301016173) |
Enumeration Date | 2011-10-11 |
Last Update Date | 2016-03-21 |