| NPI | 1568812881 |
|---|---|
| Former Name | STACY LYNN WHITTED |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-55830) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2022-07-18 |