| NPI | 1740513696 |
|---|---|
| Former Name | MELISSA ANN PORTILLOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM 0129951) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2014-09-02 |