Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-18-9447 |
NPI | 1053877282 |
---|---|
Provider Name | Cassie Louise Dupras |
First Address | Marquette, MI 49855-4661 |
Second Address | Marquette, MI 49855-4661 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2019 |
Last Update Date | 12/02/2019 |