NPI | 1629556006 |
---|---|
Former Name | MADISON LUCILLE TREMPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201012830) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-07-30 |
Last Update Date | 2022-04-01 |