NPI | 1396371506 |
---|---|
Former Name | HEATHER DAWN MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-19-109452) |
Enumeration Date | 2020-03-19 |
Last Update Date | 2021-08-05 |