NPI | 1770056111 |
---|---|
Former Name | CASEY ELYSSA MANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-18-33358) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 1685) |
Enumeration Date | 2019-01-08 |
Last Update Date | 2024-08-05 |