| NPI | 1891348199 |
|---|---|
| Former Name | JENNA FISHBACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2023-03-03 |