| NPI | 1386365195 |
|---|---|
| Former Name | HALEY SUZANNE BLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN LBA1574) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-22-60830) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2024-07-08 |