| 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 |