| NPI | 1801260492 |
|---|---|
| Former Name | JACLYN MAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201009265) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2019-07-03 |