NPI | 1326531625 |
---|---|
Former Name | BREANNA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 5608) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX 18-04855) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2023-02-01 |