NPI | 1851809511 |
---|---|
Former Name | REGINA LYNN MCDADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA 00002031) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-17-41190) |
Enumeration Date | 2018-01-16 |
Last Update Date | 2018-01-16 |