Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | ||
N | 156F00000X | Technician/Technologist |
NPI | 1245749217 |
---|---|
Provider Name | Megan Austin |
First Address | Kalamazoo, MI 49007-3860 |
Second Address | Kalamazoo, MI 49007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2017 |
Last Update Date | 06/08/2019 |