| NPI | 1407459639 |
|---|---|
| Former Name | TRACIE SPANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2023-05-12 |