NPI | 1629514757 |
---|---|
Former Name | MADISON COLLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: SC 1-16-24628) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 2168) |
Enumeration Date | 2017-01-12 |
Last Update Date | 2020-02-12 |