Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1003304858 |
---|---|
Provider Name | Allyson Whalen |
First Address | Grand Rapids, MI 49507-1526 |
Second Address | Grand Rapids, MI 49507-1526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2018 |
Last Update Date | 21/07/2021 |