Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 1-16-23064 | OH |
NPI | 1033439450 |
---|---|
Provider Name | Kristen Sell |
First Address | Detroit, MI 48278-1625 |
Second Address | Westerville, OH 43081-2890 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2010 |
Last Update Date | 28/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08258 | (05) | OH |