Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1144769266 |
---|---|
Provider Name | Kayla Parr |
First Address | Brown City, MI 48416-9510 |
Second Address | Brown City, MI 48416-9510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2017 |
Last Update Date | 22/02/2017 |