NPI | 1548831704 |
---|---|
Former Name | GRACE CORNELISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 0-24-15293) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-17-42634) |
Enumeration Date | 2021-07-08 |
Last Update Date | 2024-06-03 |