NPI | 1942572748 |
---|---|
Former Name | ALEXANDRA TELK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-16-21339) |
Additional Taxonomies | 222Q00000X Developmental Therapist |
Enumeration Date | 2012-02-08 |
Last Update Date | 2023-07-12 |