Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | ||
Y | 156F00000X | Technician/Technologist |
NPI | 1144719063 |
---|---|
Provider Name | Candace A Cummings |
First Address | Southgate, MI 48195-3047 |
Second Address | Southgate, MI 48195-3047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2018 |
Last Update Date | 10/01/2022 |