NPI | 1962637637 |
---|---|
Former Name | TARA EDMONSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 363) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 841964) |
Enumeration Date | 2009-05-23 |
Last Update Date | 2020-02-05 |