Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003322942 |
---|---|
Provider Name | Melissa L. Harrison |
First Address | Mansfield, OH 44907-1571 |
Second Address | Mansfield, OH 44907-1571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2017 |
Last Update Date | 25/02/2019 |