| NPI | 1871892604 |
|---|---|
| Former Name | MICHELE RENEE MULLENDORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2011004826) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MO 2011004826) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2023-02-21 |