Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1013549062 |
---|---|
Provider Name | Bianca Burch |
First Address | Lansing, MI 48917-5163 |
Second Address | Lansing, MI 48917-5163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2020 |
Last Update Date | 07/02/2020 |