| NPI | 1457987786 |
|---|---|
| Former Name | TAYLOR JACQUELYN FOUNTAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1-24-74791) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2025-01-23 |