Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | MI |
NPI | 1003489782 |
---|---|
Provider Name | Macie Lynn Garza |
First Address | Akron, MI 48701-9519 |
Second Address | Akron, MI 48701-9519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2021 |
Last Update Date | 21/07/2021 |