NPI | 1649417585 |
---|---|
Former Name | AMY ELIZABETH ELVINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 4454) |
171W00000X Contractor | |
Enumeration Date | 2009-01-14 |
Last Update Date | 2017-12-21 |