Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003326992 |
---|---|
Provider Name | Meghan Mcgovern |
First Address | Chesterfield, MI 48051-3930 |
Second Address | Chesterfield, MI 48051-3930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2017 |
Last Update Date | 04/10/2017 |