Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-17-27054 | MI |
N | 106E00000X | Assistant Behavior Analyst | 0-16-7360 | MI |
NPI | 1083065312 |
---|---|
Provider Name | Lauren Quinlan |
First Address | Lakeland, MI 48143-0663 |
Second Address | Owosso, MI 48867 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2016 |
Last Update Date | 03/09/2019 |