| NPI | 1497319610 |
|---|---|
| Former Name | SAMANTHA JO BULLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OR 1-21-52165) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2021-08-18 |