NPI | 1417371055 |
---|---|
Former Name | LINNAYA MANGRUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101005566) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2014-02-18 |
Last Update Date | 2019-09-16 |