| NPI | 1578119806 |
|---|---|
| Former Name | SHELBY POTTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KS 1-19-38659) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2020-06-12 |