NPI | 1669826012 |
---|---|
Former Name | JESSICA ADELLE SIVAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: RI LBA00127) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-17-27537) |
Enumeration Date | 2016-04-21 |
Last Update Date | 2025-08-25 |