Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1104222637 |
---|---|
Provider Name | Christine Engelhardt |
First Address | Lakeland, MI 48143-0663 |
Second Address | Saginaw, MI 48638-5977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2014 |
Last Update Date | 17/03/2018 |