| NPI | 1366856759 |
|---|---|
| Former Name | KRISTINA WAGONER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-18-32295) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2021-07-20 |