NPI | 1518556133 |
---|---|
Former Name | SHAMARLA TEAKE PARKS-BULLARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-79741) |
Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-24-15117) |
Enumeration Date | 2021-01-18 |
Last Update Date | 2025-03-05 |