Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003419326 |
---|---|
Provider Name | Hayleigh Lynn Bain |
First Address | Saginaw, MI 48604-9284 |
Second Address | Saginaw, MI 48604-9284 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2020 |
Last Update Date | 19/11/2020 |