Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003343336 |
---|---|
Provider Name | Melanie Kay Mcdaniel |
First Address | San Tan Valley, AZ 85143-5736 |
Second Address | San Tan Valley, AZ 85143-5736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2017 |
Last Update Date | 17/05/2017 |