NPI | 1851921480 |
---|---|
Former Name | BREANNA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.2404372) |
Enumeration Date | 2020-01-23 |
Last Update Date | 2024-06-26 |