| NPI | 1811513385 |
|---|---|
| Former Name | KELLY TEAGUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IN 1-21-52332) |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2024-01-26 |