| NPI | 1619669801 |
|---|---|
| Former Name | PAYTON REBECCA GRISSOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133003961) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2024-11-05 |