Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-16-24827 | IN |
NPI | 1003355199 |
---|---|
Provider Name | Lisa Schultz |
First Address | Muncie, IN 47304-1775 |
Second Address | Muncie, IN 47304-1775 |
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 |