NPI | 1659838860 |
---|---|
Former Name | SAMANTHA DYKEMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MI 5202008675) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-02-23 |
Last Update Date | 2021-10-28 |