Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003413956 |
---|---|
Provider Name | Lillian Dotson |
First Address | Okemos, MI 48864-2560 |
Second Address | Ann Arbor, MI 48108-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2020 |
Last Update Date | 05/10/2020 |