| NPI | 1558859355 |
|---|---|
| Former Name | MEGAN JESSICA LEWIS |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2022020359) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2024-07-10 |