NPI | 1417184730 |
---|---|
Former Name | TRACY ALICE TEETER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-06-12 |
Last Update Date | 2022-11-22 |