Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003323452 |
---|---|
Provider Name | Carvalles Snorton |
First Address | Clinton Township, MI 48038-1155 |
Second Address | Clinton Township, MI 48038-1155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2018 |
Last Update Date | 08/01/2018 |