| NPI | 1588035125 |
|---|---|
| Former Name | STEFANIE SHANNON FILLERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-09-5575) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 816) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2016-10-25 |