| NPI | 1679037063 | 
|---|---|
| Former Name | MEGAN EILLEEN CAROLAN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA BH000703) | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: DE 103K00000X) | 
| Enumeration Date | 2019-01-30 | 
| Last Update Date | 2019-08-09 |