NPI | 1811986300 |
---|---|
Former Name | LINDA MCCLELLAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-000703) |
Enumeration Date | 2005-10-18 |
Last Update Date | 2021-09-13 |