| NPI | 1649787383 |
|---|---|
| Former Name | AMANDA LYNN LARESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-17-28349) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2022-05-03 |