NPI | 1548620248 |
---|---|
Former Name | KRISTA LEE GENGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 2539) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 1-15-18452) |
103K00000X Behavior Analyst (Licence: TX 11518452) | |
Enumeration Date | 2016-02-24 |
Last Update Date | 2025-06-19 |