| NPI | 1710336490 |
|---|---|
| Former Name | ANGELA VANCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MD LBA203) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133000718) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2019-02-27 |