| NPI | 1386169399 |
|---|---|
| Former Name | TARA PETTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-19-37303) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2025-04-03 |