| NPI | 1376082099 |
|---|---|
| Former Name | JILLIAN GANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2019-12-27 |