| NPI | 1629534631 |
|---|---|
| Former Name | RANDI MICHELLE THORNBURG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-08-06 |